title: Predicting recreational difficulties and decreased leisure activities in women 6-12 months post breast cancer surgery.
abstract: BACKGROUND
  A Canadian research team is conducting a multi-centered, non-interventional national study with the objective of charting the course of arm morbidity after breast cancer surgery. This paper examined the relationship between arm morbidity and leisure and recreational activities of affected women.
  
  
  METHODS
  Five hundred and forty seven women with stage I-III breast cancer were recruited in four centers across Canada: Surrey (BC); Winnipeg (MB), Montreal (QB) and Fredericton (NB). Participants were enrolled in the study 6-12 months post surgery. Physical examination was used to assess arm and shoulder functioning and questionnaires were used to assess disability, pain, and participation in recreational and leisure activities.
  
  
  RESULTS
  At the first clinical assessment (T1), the mean number of months post breast cancer surgery was 8.4. At T1 49% of women reported difficulty with recreational activities that involved "some force or impact" and 29% experienced negative changes to their involvement in leisure activities. A hierarchical multiple regression analysis found that several arm morbidity variables were significant predictors of difficulty with participation in recreational activities. A second hierarchical regression found also that arm morbidity factors were significant predictors of negative changes in leisure activities. Follow-up analyses found that arm morbidity, was most closely related to difficulty with recreational activities requiring free movement of the arm and using force.
  
  
  CONCLUSIONS
  Many women treated for breast cancer experience arm morbidity. Arm morbidity is related to difficulties with recreational activities and negative changes in leisure activity participation.
  
  
  CONCLUSIONS
  Breast cancer survivors should engage in recreational and leisure activities that are compatible with reduced range of motion and pain, and avoid those that exacerbate their arm morbidity.
authors.affiliation: Dalhousie University Family Medicine Teaching Unit, Dr. Everett Chalmers Regional Hospital, 700 Priestman Street, Fredericton, NB, Canada. bo.miedema@rvh.nb.ca
authors.forename: Baukje
authors.initials: B
authors.lastname: Miedema
authors.forename: Ryan
authors.initials: R
authors.lastname: Hamilton
authors.forename: Sue
authors.initials: S
authors.lastname: Tatemichi
authors.forename: Roanne
authors.initials: R
authors.lastname: Thomas-MacLean
authors.forename: Anna
authors.initials: A
authors.lastname: Towers
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Hack
authors.forename: Andrea
authors.initials: A
authors.lastname: Tilley
authors.forename: Winkle
authors.initials: W
authors.lastname: Kwan
mesh_terms: D000368:Aged; D001132:Arm / Q000503:physiopathology*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007899:Leisure Activities; D008209:Lymphedema / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D008875:Middle Aged; D009038:Motion; D009043:Motor Activity / Q000502:physiology; D010147:Pain Measurement; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors